<?php echo form_open('staffprofile/editstaffchecklist/'.$staffId,array('class'=>'form-horizontal','id'=>'frm'));?>
<fieldset>
    <legend><h4><?php echo $title;?></h4></legend>
    <div class="control-group">
	    <label class="control-label">Contract</label>
	    <div class="controls">
	       <input type="checkbox" name="Contract" <?php if($checklist['Contract'] == '1') echo 'checked="checked"'; ?> />
	    </div>
  	</div>
    <div class="control-group">
	    <label class="control-label">Code Conduct</label>
	    <div class="controls">
	      <input type="checkbox" name="CodeConduct" <?php if($checklist['CodeConduct'] == '1') echo 'checked="checked"'; ?> />
	    </div>
  	</div>
  	 <div class="control-group">
	    <label class="control-label">Conflict Interest</label>
	    <div class="controls">
	      <input type="checkbox" name="ConflictInterest" <?php if($checklist['ConflictInterest'] == '1') echo 'checked="checked"'; ?> />
	    </div>
  	</div>
  	 <div class="control-group">
	    <label class="control-label">IRMeeting</label>
	    <div class="controls">
	      <input type="checkbox" name="IRMeeting" <?php if($checklist['IRMeeting'] == '1') echo 'checked="checked"'; ?> />
	    </div>
  	</div>
  	<div class="control-group">
	    <label class="control-label">SelfDecForm</label>
	    <div class="controls">
	      <input type="checkbox" name="SelfDecForm" <?php if($checklist['SelfDecForm'] == '1') echo 'checked="checked"'; ?> />
	    </div>
  	</div>
  	<div class="control-group">
	    <label class="control-label">PerInfoForm</label>
	    <div class="controls">
	      <input type="checkbox" name="PerInfoForm" <?php if($checklist['PerInfoForm'] == '1') echo 'checked="checked"'; ?>/>
	    </div>
  	</div>
  	<div class="control-group">
	    <label class="control-label">Email</label>
	    <div class="controls">
	      <input type="checkbox" name="Email" <?php if($checklist['Email'] == '1') echo 'checked="checked"'; ?> />
	    </div>
  	</div>
  	<div class="control-group">
	    <label class="control-label">Bank Account</label>
	    <div class="controls">
	       <input type="checkbox" name="BankAccount" <?php if($checklist['BankAccount'] == '1') echo 'checked="checked"'; ?>/>
	    </div>
  	</div>
  	<div class="control-group">
	    <label class="control-label">Staff DisCard</label>
	    <div class="controls">
	       <input type="checkbox" name="StaffDisCard" <?php if($checklist['StaffDisCard'] == '1') echo 'checked="checked"'; ?>/>
	    </div>
  	</div>
  	<div class="control-group">
	    <label class="control-label">SendBD</label>
	    <div class="controls">
	      <input type="checkbox" name="SendBD" <?php if($checklist['SendBD'] == '1') echo 'checked="checked"'; ?> />
	    </div>
  	</div>
  	<div class="control-group">
	    <label class="control-label">StaffProfile</label>
	    <div class="controls">
	      <input type="checkbox" name="StaffProfile" <?php if($checklist['StaffProfile'] == '1') echo 'checked="checked"'; ?>/>
	    </div>
  	</div>
  	<div class="control-group">
	    <label class="control-label">Insurance State</label>
	    <div class="controls">
	       <input type="checkbox" name="InsuranceState" <?php if($checklist['InsuranceState'] == '1') echo 'checked="checked"'; ?> />
	    </div>
  	</div>
   	<div class="control-group">
	    <label class="control-label">Visa</label>
	    <div class="controls">
	       <input type="checkbox" name="Visa" <?php if($checklist['Visa'] == '1') echo 'checked="checked"'; ?>/>
	    </div>
  	</div>
    <div class="control-group">
	    <label class="control-label">Visa End Date</label>
	    <div class="controls">
	       <input type="text" name="VisaDate" class="datepicker" value="<?php echo $checklist['VisaDate'];?>" />
	    </div>
  	</div>
  	<div class="control-group">
	    <label class="control-label">Remark</label>
	    <div class="controls">
	       <textarea name="Remark" rows="3"><?php echo $checklist['Remark'];?></textarea>
	    </div>
	 </div>
    <?php echo $form; ?>
 </fieldset> 

<?php echo form_close();?>